Techniques in Extracorporeal Circulation 4E

373 Pages·2004·5.984 MB·English

by  Kay, Philip

Techniques in
extracorporeal
circulation
This page intentionally left blank
Techniques in
extracorporeal
circulation
FOURTH EDITION
Edited by
PHILIP H KAY MA DM FRCS
Consultant Cardiothoracic Surgeon,
Yorkshire Heart Centre,
The General Infirmary,
Leeds, UK
and
CHRISTOPHER M MUNSCH ChM FRCS (C/Th)
Consultant Cardiothoracic Surgeon,
Yorkshire Heart Centre,
The General Infirmary,
Leeds, UK
A member ofthe Hodder Headline Group
LONDON
First published in 1976 by Butterworth-Heinemann Ltd,
Linacre House, Jordan Hill, Oxford, OX2 8DP.
This edition published in Great Britain in 2004 by
Arnold, a member of the Hodder Headline Group,
338 Euston Road, London NW1 3BH
http://www.arnoldpublishers.com
First published 1976
Second edition 1981
Reprinted 1982
Third edition 1992
Reprinted 1993
Fourth edition 2004
Distributed in the United States of America by
Oxford University Press Inc.,
198 Madison Avenue, New York, NY10016
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©2004 Arnold
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Whilst the advice and information in this book are believed to be true and
accurate at the date of going to press, neither the author[s] nor the publisher
can accept any legal responsibility or liability for any errors or omissions
that may be made. In particular (but without limiting the generality of the
preceding disclaimer) every effort has been made to check drug dosages;
however, it is still possible that errors have been missed. Furthermore, dosage
schedules are constantly being revised and new side-effects recognized.
For these reasons the reader is strongly urged to consult the drug companies’
printed instructions before administering any of the drugs recommended in
this book.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
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A catalog record for this book is available from the Library of Congress
ISBN 0 340 80723 7
1 2 3 4 5 6 7 8 9 10
Commissioning Editor: Joanna Koster
Development Editor: Sarah Burrows
Project Editor: Zelah Pengilley
Production Controller: Deborah Smith
Cover Design: Lee-May Lim
Indexer: Laurence Errington
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Printed and bound in Great Britain by Butler & Tanner Ltd
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Contents
Contributors vii
Foreword xi
Preface to Fourth Edition – 50 years on xiii
Preface to Third Edition xiv
Preface to Second Edition xv
Preface to First Edition xvi
Acknowledgements xvii
1 A brief history of bypass 1
Anil Kumar Mulpur and Christopher M Munsch
2 Design and principles of the extracorporeal circuit 7
Medtronic, Inc., A Manufacturer of Technologies for Extracorporeal Circulation
3 Physiology and pathophysiology of extracorporeal circulation 23
Jonathan AJ Hyde and Ralph E Delius
4 Anaesthesia for cardiopulmonary bypass 57
Linda Nel and John WW Gothard
5 Monitoring and safety in cardiopulmonary bypass 76
Jonathan M Johnson, Stephen Robins and Jonathan AJ Hyde
6 Priming fluids for cardiopulmonary bypass 99
Piet W Boonstra and Y John Gu
7 Filters in cardiopulmonary bypass 108
Farah NK Bhatti and Timothy L Hooper
8 The inflammatory response to cardiopulmonary bypass 117
Saeed Ashraf
9 Pulsatile cardiopulmonary bypass 133
Terry Gourlay and Kenneth M Taylor
10 Cardiopulmonary bypass and the brain 148
G Burkhard Mackensen, Hilary P Grocott and Mark F Newman
vi Contents
11 Cardiopulmonary bypass in children with congenital heart disease 177
Carin van Doorn and Martin Elliott
12 Intraoperative myocardial protection 184
John WC Entwistle III and Andrew S Wechsler
13 Blood conservation 210
Mike Cross
14 Mechanical circulatory support 236
Stephen Westaby and Satoshi Saito
15 Extracorporeal membrane oxygenation 254
Scott K Alpard, Dai H Chung and Joseph B Zwischenberger
16 The extended use of the extracorporeal circuit 292
Philip H Kay, Anil Kumar Mulpur, Dumbor Ngaage, Samir Shah, Kieran Horgan,
John Pollitt and Stephen D Hansbro
17 Cardiopulmonary bypass during Port-access™ and robotic surgery 298
Alan P Kypson and W Randolph Chitwood Jr
18 Cardiac surgery without cardiopulmonary bypass 315
Joseph P McGoldrick
19A The development of clinical perfusion education and standards in the UK and Ireland 332
Michael Whitehorne
19B Standards, guidelines and education in clinical perfusion: the European perspective 337
Ludwig K Von Segesser
19C Perfusion education in the USA at the turn of the twentieth century 341
Alfred H Stammers
Index 345
Contributors
Scott K Alpard MD Mike Cross
Surgical Research Fellow, Consultant Anaesthetist,
Division of Cardiothoracic Surgery, Yorkshire Heart Centre,
University of Texas Medical Branch, The General Infirmary at Leeds,
Galveston, TX, USA Leeds, UK
Saeed Ashraf FRCS(CTh)MD Ralph E Delius MD
Consultant Cardiothoracic Surgeon,
Children’s Hospital of Michigan,
Regional Cardiothoracic Centre,
Detroit, MI, US
The Morriston Hospital, and Honorary Senior Lecturer,
University of Swansea,
Carin van Doorn
Swansea, UK
Senior Lecturer in Cardiothoracic Surgery,
University College London,
Farah NK Bhatti
and Honorary Consultant Cardiothoracic Surgeon,
Specialist Registrar in Cardiothoracic Surgery,
Cardiothoracic Unit,
Wythenshawe Hospital,
Great Ormond Street Hospital for Children,
Manchester, UK
London, UK
Piet W Boonstra
Department of Cardiothoracic Surgery, Martin Elliott
University Hospital, Consultant Cardiothoracic Surgeon,
Groningen, The Netherlands Cardiothoracic Unit,
Great Ormond Street Hospital for Children,
Walt Carpenter London, UK
Director of Cardiopulmonary R&D,
Medtronic Perfusion Systems,
John WC Entwistle III MDPhD
Minneapolis, MN, USA
Assistant Professor of Cardiothoracic Surgery,
Department of Cardiothoracic Surgery,
W Randolph Chitwood Jr MD
Drexel University College of Medicine,
Senior Associate Vice Chancellor and Director,
Philadelphia, PA, USA
North Carolina Cardiovascular Institute,
Professor and Chairman,
Professor of Surgery, John WW Gothard FRCA
Consultant Anaesthetist,
Chief, Division of Cardiothoracic and Vascular Surgery,
Royal Brompton Hospital,
The Brody School of Medicine,
London, UK
East Carolina University,
Greenville, NC, USA
Terry Gourlay PhDBSc(Hons)CBiolMIBiolILTHEFRSH
Dai H Chung MD British Heart Foundation Perfusion Specialist,
Assistant Professor of Surgery, Department of Cardiothoracic Surgery,
Chief, Section of Pediatric Surgery, NHLI,
Department of Surgery, Imperial College Medical School,
University of Texas Medical Branch, Hammersmith Hospital Campus,
Galveston, TX, USA London, UK
viii Contributors
Hilary P Grocott MDFRCPC G Burkhard Mackensen MD
Associate Professor, Assistant Professor,
Department of Anesthesiology, Klinik für Anaesthesiologie,
Duke Heart Center, Technische Universität München,
Duke University Medical Center, Klinikum rechts der Isar,
Durham, NC, USA München, Germany
Joseph P McGoldrick MDFRCS
Y John Gu
Consultant Cardiothoracic Surgeon,
Department of Cardiothoracic Surgery,
The Yorkshire Heart Centre,
University Hospital,
The General Infirmary at Leeds,
Groningen, The Netherlands
Leeds, UK
Stephen D Hansbro Anil Kumar Mulpur MSMChFRCS(Edin)
Department of Clinical Perfusion, FRCS(Glasgow)FRCSC/Th(Edin)FETCS
Leeds General Infirmary, Consultant Cardiothoracic Surgeon,
Leeds, UK Sri Sathya Sai Institute of Higher Medical Sciences,
Whitefield, Bangalore, India
Timothy L Hooper
Christopher M Munsch ChMFRCS(C/Th)
Consultant Cardiac Surgeon,
Consultant Cardiothoracic Surgeon,
Wythenshawe Hospital,
Department of Cardiothoracic Surgery,
Manchester, UK
The Yorkshire Heart Centre,
The General Infirmary,
Kieran Horgan
Leeds, UK
Department of General Surgery,
Leeds General Infirmary, Linda Nel FRCA
Leeds, UK Consultant Anaesthetist,
Southampton University Hospitals Trust,
Southampton, UK
Jonathan AJ Hyde MDFRCS(CTh)
Consultant Cardiac Surgeon,
Mark F Newman MD
Royal Sussex County Hospital,
Professor and Chairman,
Brighton, UK
Department of Anesthesiology,
Duke Heart Center,
Jonathan M Johnson BScACP Duke University Medical Center,
Chief Clinical Perfusionist, Durham, NC, USA
Royal Sussex County Hospital,
Dumbor Ngaage
Brighton, UK
Department of Cardiothoracic Surgery,
Leeds General Infirmary,
Bruce Jones
Leeds, UK
Cardiopulmonary Product Manager,
Medtronic Perfusion Systems, John Pollitt
Minneapolis, MN, USA Department of General Surgery,
Leeds General Infirmary,
Philip H Kay MADMFRCS Leeds, UK
Consultant Cardiothoracic Surgeon,
Stephen Robins PgDipAACP
The Yorkshire Heart Centre,
Chief Clinical Perfusionist,
The General Infirmary,
New Cross Hospital,
Leeds, UK
Wolverhampton, UK
Alan P Kypson MD Satoshi Saito MDPhD
Assistant Professor of Surgery, Senior Clinical Research Fellow,
Division of Cardiothoracic Surgery, Department of Cardiothoracic Surgery,
Brody School of Medicine, Oxford Heart Centre,
East Carolina University, John Radcliffe Hospital,
Greenville, NC, USA Oxford, UK
Contributors ix
Ludwig K Von Segesser Andrew S Wechsler MD
Service de Chirurgie Cardio-Vasculaire, Professor and Chairman,
Centre Hospitalier Universitaire Vaudois (CHUV), Department of Cardiothoracic Surgery,
Lausanne, Switzerland Drexel University College of Medicine,
Philadelphia, PA, USA
Samir Shah
Department of Cardiothoracic Surgery, Stuart Welland
Leeds General Infirmary, European Marketing Manager,
Leeds, UK Medtronic Europe Sàrl,
Tolochenaz, Switzerland
Alfred H Stammers MSACCP
Chief Perfusionist, Stephen Westaby PhDFETCSMS
Department of Surgery, Consultant Cardiac Surgeon,
Geisinger Medical Center, Department of Cardiothoracic Surgery,
Danville, PA, USA Oxford Heart Centre,
John Radcliffe Hospital,
Editor, Journal of Extracorporeal Technology
Oxford, UK
Jeanne Stanislawski
Michael Whitehorne MSCACPFCCPS
Cardiopulmonary Product Manager,
Consultant Clinical Perfusion Scientist,
Medtronic Perfusion Systems,
Department of Cardiothoracic Surgery,
Minneapolis, MN, USA
King’s College Hospital,
London, UK
Wendy Svee
Cardiopulmonary Product Manager,
Joseph B Zwischenberger MD
Medtronic Perfusion Systems,
Professor of Surgery, Medicine, and Radiology,
Minneapolis, MN, USA
Director, General Thoracic Surgery and ECMO Programs,
Kenneth M Taylor Division of Cardiothoracic Surgery,
Professor of Cardiac Surgery, University of Texas Medical Branch,
Department of Cardiothoracic Surgery, Galveston, TX, USA
NHLI,
Imperial College Medical School,
Hammersmith Hospital Campus,
London, UK